Healthcare Provider Details
I. General information
NPI: 1285186049
Provider Name (Legal Business Name): ARTHRITIS AND RHEUMATOLOGY CENTER OF MI PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2016
Last Update Date: 12/12/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
135 BARCLAY CIR STE 100
ROCHESTER HILLS MI
48307-4599
US
IV. Provider business mailing address
135 BARCLAY CIR STE 100
ROCHESTER HILLS MI
48307-4599
US
V. Phone/Fax
- Phone: 248-852-2277
- Fax: 248-659-1655
- Phone: 248-852-2277
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | 5101102450 |
| License Number State | MI |
VIII. Authorized Official
Name:
SRIJANA
PRADHAN
BAKSHI
Title or Position: PRESIDENT
Credential: MD
Phone: 248-686-8426